Breakaway interfacing of radiological images with work orders

ABSTRACT

A breakaway interface between radiological information systems, imaging equipment and picture archive and communications systems has automated filtering and handling of multiple study work orders or affiliated work orders, while passing single study work orders through unaltered. The work orders are processed by the breakaway interface to consolidate multiple procedure or multiple study work orders into a single super order, which is then communicated, preferably using DICOM standard protocol, to an imaging machine. The imaging machine returns a single image sequence, and the breakaway interface will then break images away from the single image sequence into a plurality of grouped image sequences. The preferred grouping is based upon anatomical regions, and separate but adjacent anatomical regions will preferably share one or more images at the boundary between the adjacent regions. The exact number of shared images may preferably be preset at the system level. A number of different techniques for analyzing the single image sequence are proposed individually or in combination, including histogram analysis, peak finding techniques, moments of order analysis, evaluating information from one or more previous analyses, and evaluating image sequence series information to distinguish discrete imaging procedures.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation in part of U.S. application Ser. No.10/667,947, filed Sep. 22, 2003, now U.S. Pat. No. 7,756,725, whichclaims priority to U.S. provisional Application No. 60/437,556 filed onDec. 31, 2002 and incorporated herein by reference in its entirety.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention pertains generally to computer-aided imaging systems andcomputer-aided radiological information systems. More specifically, thepresent invention incorporates image analysis and work order evaluationto ensure that a radiological information system and computer-aidedimaging system produce desired and matched images and work orders in anautomated and reliable manner.

2. Description of the Related Art

Radiological information systems provide a hospital, imaging or othermedical facility appropriate computer software tools to manageinformation regarding radiological exams. Modern radiological imagingfacilities will typically utilize a variety of highly sophisticatedtesting, imaging and analysis equipment. For exemplary purposes only,and not limited thereto, exemplary imaging equipment commonly found atsuch facilities may include CT, SPECT, PET, and MRI scanners. Thesemachines are very expensive assets that will most desirably be operatedin an efficient manner to minimize idle time and, simultaneously, tominimize the amount of time required to produce a desired set of imagesfor a given patient. By minimizing the time required for a patient, thethroughput on a given machine may be increased, decreasing the totalcost per patient and reducing the need for additional machines thatmight be otherwise required to maintain a particular level of service.The patients will also see better service through reduced waiting timeand fewer retakes or extra visits for missed or overlooked imagerequests.

The operations which are provided for through the radiologicalinformation system will typically include scheduling, billing, tracking,generation of work orders, storage of reference information such asreferring physician, patient information, and the like. Such systemsform an important accounting and management role within a well-managedfacility and so are a vital part of the administrative data management.

In addition to the administrative scheduling and accounting functions ofa typical radiological information system, additional management isrequired when receiving, handling and archiving radiological images. Inparticular, recent imaging systems are capable of generating eithersingle images or, alternatively, a relatively large number of relativelysmall image slices. These slices may not be evenly distributed across apatient's body, but in accord with a physicians' needs may be unevenlyconcentrated in a particular body area or region. For exemplarypurposes, multi-slice CT equipment is capable of producing hundreds ofslices in a single very short scanning session, and the equipment iscapable of scanning from the top of a person's head through the pelvisin a single acquisition. Multiple separate procedures or anatomicalstudies may be included in a single CT acquisition. The maintenance ofthis image data, which generally involves the archiving of large amountsof data, is most preferably handled through specialized computer systemsreferred to herein as Picture Archive and Communication Systems (PACS).A PACS system will most desirably incorporate much specialized softwarewhich enables specialized handling and display of the images, and willmost preferably work cooperatively as a part of or in close associationwith the radiological information system.

Unfortunately, the objectives of the various systems are somewhatdifferent from each other, and, as a result, certain technicalchallenges are present in the integration of the various components thatcomprise a complete radiological program. For example, to facilitatebilling most radiological information systems require a specific workorder be associated with each image set. That way, there is a clearaccounting trail of work ordered and delivered, and the system canthereby ensure that the orders have properly been fulfilled and billed.This approach works very well for single study work orders. The workorder may be generated without intelligent intervention, and theradiology technician can conduct the single study as ordered. Whencomplete, the radiologist will generate a single radiology report andthe facility will then deliver and bill for the study.

Unfortunately, when there is a multi-anatomical study or multi-procedurestudy work order placed, which is very well handled by many axialmedical imaging scanners, neither the PACS system nor the radiologicalinformation system are well suited. Prior to the present invention, thepersons entering or tracking the information would be called upon torecognize that the request was for a plurality of studies. In order forthe radiological information system and the PACS to accurately accountfor this multi-study, a person would have to enter the work ordermanually by dividing the work order into a plurality of work orders.When the work order was not divided and manually entered, only oneimaging study could be assigned to or electronically associated with thework order. Not only is a radiological information system designed toaccount for each study separately, but the PACS associates only oneprocedure with the study. Consequently, for a multi-anatomical study,the remaining image studies could not be assigned by the readingradiologist, and these studies remained unassigned and not associatedwith any particular work order. As a result, the facility was unable toproperly account, track and bill for the remaining image studies.

As aforementioned, the prior art manual intervention is not limitedsolely to the entry of information into the radiological informationsystem. Once the multi-study is properly entered into the radiologicalinformation system, including dividing into each individual study, thework order is conveyed to a technician responsible for conducting aparticular study. In the case of a multi-anatomical study, such as forexemplary purposes only and not limiting thereto, a CT scan coveringhead, neck and upper torso, the CT technician will most desirablyrecognize that the patient can be positioned for a single comprehensiveprocedure. The work orders, however, indicate three separate procedures,a discrepancy that may, particularly in the case of a new orless-experienced technician, lead to error, confusion or delay, any ofwhich is associated with a decreased level of service and the potentialneed to expose the patient multiple times to the imaging radiant energy.

When the CT technician properly completes the single comprehensiveprocedure, yet another problem exists. The work order has multiplestudies specified, and yet there is only a single imaging sequenceproduced by the imaging equipment. Consequently, interpretation andmanual intervention are once again required. This time, the technicianmust review the images and determine an appropriate grouping tocorrespond to the work order, or a radiologist or the like willotherwise have to re-organize the single multi-study output from theequipment to attempt to match the studies to the multiple work orders.In either case, additional work not associated directly with patientcare is undesirably required.

In the event the multi-study imaging output is not divided (which istedious work not directly affiliated with patient care) issues ariseregarding the accounting between the radiology report and theradiological information system. When work orders are properly divided,but the images are not, the remaining work orders are all too frequentlyorphaned, unmatched to any image set in spite of the fact that theimaging study has actually been completed.

In either case, when work orders are not properly divided or images arenot properly divided, another very significant benefit of the PACS islost. By electronically archiving imaging information, a radiologist orother health care provider may compare present images to past imagesstored with the patient's records, and do this with almost no delay.Unfortunately, when either the work order or the imaging studies havenot been properly manually divided, the physician will find it difficultor impossible to locate the archived images to carry out the past andpresent comparisons. For example, if the patient had a full scanincluding head, neck and upper torso as described above, and the resultsof the head scan were not stored with the head scan work order, thephysician may be unable to locate the head scan, and may typicallyassume that it has been permanently lost or destroyed or waste valuabletime researching what should be an automatic display. Many PACS systemsrefer to studies by procedure type, so it is important that distinctprocedures be subdivided, or the information from the procedure may notbe retrievable using the procedure type reference. As may be understood,comparisons of current imaging information with previous imaging datacan be invaluable in the evaluation and diagnosis of a medicalcondition, and the loss of such useful information can be verydetrimental to the provision of timely and efficient patient care.

What is desired then is a system which eliminates the tedious andunreliable manual intervention, and thereby allows the users of eachsystem to better focus their efforts on their primary duties.

SUMMARY OF THE INVENTION

The present invention provides, for use in combination with medicalimaging equipment normally operating independently of a stand-aloneradiological information system, a breakaway interface disposed betweenthe radiological information system and PACS and the medical imagingequipment. This breakaway interface facilitates conventional use of themedical imaging equipment for multi-anatomical or multi-proceduralstudies for generating a series of anatomical images under a single workorder and for simultaneously producing respective individual work orderswhich are matched to corresponding anatomical images, and which areinputted into the radiological information system for managementcontrol, tracking, accounting and/or billing purposes.

Preferably, a picture archive and communication system (PACS) isprovided for transmitting individual work orders and storing theanatomical images into the PACS. In a first manifestation, the breakawayinterface is operative between a radiology accounting and billinginformation system having one-to-one correspondence between individualradiological studies and individual work orders, a picture archive andcommunication system (PACS) having one-to-one correspondence betweenindividual radiological studies and individual work orders, and aradiological imaging machine that produces multiple studies from asingle work order. Means are provided within the breakaway interface forreceiving an image sequence from the radiological imaging machine. Meansare also provided for dividing the image sequence into separate,anatomically associated image sequences. Means are additionally providedfor matching anatomically associated images with correspondingindividual work orders. Additional means transmit the matchedanatomically associated image sequences and corresponding individualwork orders to the picture archive and communication system.

In a second manifestation, the invention is a method of separating asingle radiological image sequence comprising a plurality of individualradiological images into a plurality of sequences and associating theplurality of sequences with a plurality of associated studies and workorders. According to the method, the single radiological image sequenceis received in electronic form. Individual radiological images withinthe sequence are analyzed, preferably using histogram analysis, momentsof order analysis and peak finding techniques, info from previousanalysis steps, and the evaluation of series information to distinguishbetween multiple procedures, to determine an associated anatomicalregion. The individual radiological images are assigned to anappropriate one of the plurality of associated studies and work ordersbased upon the analysis and determination.

In a third manifestation, the invention is a method of processingradiological orders using a radiological information system containingradiological examination orders and associated information, a picturearchive and communication system, and an imaging apparatus capable ofproducing an image sequence having a plurality of individual imagestherein, including interfacing the radiological information system, thepicture archive and communication system and the imaging apparatus in aneffective and efficient manner. According to the method, examinationorders are received from the radiological information system, and thendistinguished by whether the orders are unaffiliated with otherexamination orders or not. Affiliated examination orders are assembledinto a super order. Unaffiliated examination orders and super orders areconveyed to the imaging apparatus for imaging, which will generate imagesequences having at least one individual radiological imagecorresponding to unaffiliated examination orders and super orders. Theimage sequences corresponding to unaffiliated examination orders aredelivered to the picture archive and communication system withoutfurther processing. Images within image sequences corresponding to superorders are analyzed, preferably using histogram analysis and peakfinding techniques, information from previous analysis steps, and byevaluating series info to distinguish multiple procedures, to determinean associated anatomical region. Based upon the analyzing anddetermining, individual radiological images are assigned to anappropriate one of the associated studies and work orders. Finally,individual radiological images and associated studies and work ordersare transmitted to the picture archive and communication system forfurther processing.

OBJECTS OF THE INVENTION

A first object of the invention is to provide improved and more highlyautomated communication between a radiological information system and aradiological imaging machine. A second object of the invention is toreduce the need for human intervention and interpretation, andconsequently reduce the likelihood for errors. A third object of theinvention is to ensure that appropriate information is stored with eachappropriate work order, whereby at a later date the imaging informationmay be readily obtained for review and comparison. A fourth object ofthe invention is to permit both a radiological information system and aradiological imaging machine to be operated using native logic andassociated work orders, whereby the benefits of each system arepreserved and allowed to remain optimal for their intended purposes.Another object of the invention is to provide filtered conversions bothfrom a radiological information system to a radiological imaging machineand in an opposite direction from said radiological imaging machine tosaid radiological information system. A further object of the inventionis to maintain compliance with existing standards, such as the DICOMstandards. These and other objects are achieved in the presentinvention, which may be best understood by the following detaileddescription and drawing of the preferred embodiment.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates the preferred breakaway interface and associatedimaging systems designed in accord with the teachings of the presentinvention by schematic block diagram.

FIG. 2 illustrates the preferred method of processing radiologicalorders, using the preferred method of breaking away images shown in FIG.3, in accord with the teachings of the present invention by flow chart.

FIG. 3 illustrates the preferred method of breaking images away from amulti-study image sequence into individual anatomically organized imagesequences in accord with the teachings of the present invention by flowchart.

DESCRIPTION OF THE PREFERRED EMBODIMENT

A preferred embodiment breakaway apparatus 100 and breakaway method 200of interfacing radiological images with work orders is illustrated inFIGS. 1-3. As illustrated in FIG. 1, breakaway apparatus 100 couples astandard radiological information system 110 or other known or suitablesubstitute, including a PACS system, to breakaway interface 140. In thepreferred embodiment, radiological information system 110 willcommunicate to breakaway interface 140 by transmission of communicationssignals using industry standard protocols such as DICOM work lists orHL-7 orders.

Most preferably, though not essential to the workings of the presentinvention, the various components within breakaway apparatus 100 will becompliant with the DICOM industry standards. DICOM, which stands forDigital Imaging and Communications in Medicine, is the industry standardfor transfer of radiological images and other medical informationbetween computers. Patterned after the Open System Interconnection ofthe International Standards Organization, DICOM enables digitalcommunication between radiological imaging equipment and systems fromvarious manufacturers.

Compliance with the DICOM open standards is important to ensurecompatibility between radiological services providers and varioushealth-care facilities that may be physically separated one from theother. The facilities may be divided merely within buildings, or acrossdistant geographic regions. Hardware and software from diverse vendorslocated at one site or many remote sites can communicate by means of theDICOM standard across an open system network. As a result, medicalimages can be captured and communicated more quickly, allowingphysicians to make diagnoses sooner. Additionally, the use of DICOMstandard components ensures more modularity in the construction of thepreferred embodiment. Consequently, for the purposes of this disclosure,phrases such as coupling, transmitting, receiving and the like will beunderstood to include not only direct connection by local wiring, butalso to other suitable communications, including but not limited to bothphysical and virtual interconnections including local area networks,wide area networks, Internet, radio and satellite communications, and soforth.

Breakaway interface 140 includes means to receive the work lists, themeans which are dependent upon the type of network or communicationssystem in use and which includes all suitable known apparatus. Thereception means, for exemplary and not limiting purposes, may includesuch devices as network interface cards, modems, direct wiring or thelike, typically associated with appropriate software or hardware forimplementing the necessary function. The appropriate apparatus will bedetermined by those skilled in the art at the time of design.

Breakaway interface 140 will filter work lists or orders received fromradiological information system 110, as will be described in muchgreater detail with regard to FIGS. 2 and 3 herein below, and thentransmits a rationalized work list, preferably using the DICOM standardsand format, to imaging equipment 120. Similar to the above mentionedreception means, breakaway interface 140 will include appropriate meansfor transmission, once again dependent upon the type of network orcommunications system, and once again determined by those skilled in theart at design time.

Imaging equipment 120 may include one or more of a wide variety ofdiverse medical imaging equipment. The invention is believed to offersignificant benefit and advantage when applied more particularly toaxial medical imaging equipment, and most particularly to such equipmentwhen the equipment is capable of generating many image slices within avery short period of time, or processing large body sections or separateanatomical studies at once. Exemplary are current multi-slice CTscanners, which are capable of producing hundreds of slices in a shorttime interval, scanning from the top of a head through the pelvis in asingle acquisition, and processing images for five separate anatomicalstudies in a single CT sequence. Capabilities to which the presentinvention is most suited may also be found in many SPECT, PET and MRIimaging machines, though this list is strictly exemplary, and in no waylimiting to the scope of the invention.

Imaging equipment 120 in turn transmits back to breakaway interface 140an image sequence taken in accord with the rationalized DICOM work list.Once again, the image sequence will preferably be transmitted fromimaging equipment 120 to breakaway interface 140 in accord with theDICOM standards, though the invention is not so limited. Breakawayinterface 140 will include reception means suited for receiving imagesequences from imaging equipment 120, such means within the purview ofthose skilled in the art and the selection of which will be made atdesign time.

In the event the image sequence was generated from a rationalized worklist which was different from the work list received from radiologicalinformation system 110, breakaway interface 140 will include means tobreak images away from the image sequence received from imagingequipment 120 into smaller rationalized image sequences. In thepreferred embodiment, breakaway interface 140 intelligently appliesalgorithms to the images to determine the best way to split up the imagesequence, as will be described in greater detail herein below withspecific reference to FIG. 2.

Once the smaller rationalized image sequences are derived from thelarger sequence received from imaging equipment 120, breakaway interface140 includes means to communicate the smaller rationalized imagesequences to a PACS system 130 or the like. Most preferably, thecommunications protocol will conform to DICOM standards, though this isnot essential to the workings of the invention. In addition to thetransmission of the rationalized image sequences, the associations torationalized work lists or HL-7 orders will also be transmitted, therebyensuring proper one-to-one correspondence within PACS 130. The specificapparatus used will be selected by those skilled in the art from themyriad of available hardware and software combinations known in the artto be suitable for the communications required herein.

In accord with the teachings of the present invention, the provision ofbreakaway interface 140 enables users of radiological information system110 and picture archive and storage system 130 to continue to generatework orders, bills, studies, archival records and the like using thesystems as they were designed, with one-to-one work order to imagesequence and study correspondence, without special training or manualintervention for exceptions such as multiple procedure studies ormultiple-study imaging. This conformance is highly desirable, sincethese systems were designed to best ensure accurate and optimalmanagement, tracking, and archival retrieval. The avoidance of manualinterventions for exceptions is also highly desirable, since, asaforementioned, such manual intervention is extremely tedious, prone toerrors, and very much avoided in industry, to the point of seriouslyhampering the effectiveness of entire electronic radiology systems.

The input to imaging equipment 120 is additionally optimized bybreakaway interface 140, assembling super orders where appropriate,thereby reducing the clutter of pluralities of work orders for a singlescanning sequence, and also eliminating the need for manual interventionto recognize and assemble the plurality of work orders into the singlescanning sequence. Consequently, not only are the operations at theradiological information system 110 and PACS 130 optimized, but so isthe operation of imaging equipment 120.

FIG. 2 illustrates a preferred method 200 of processing radiologicalorders within breakaway interface 140. Method 200 may be implementedusing various combinations of software and hardware, as is known in theart. Consequently, method 200 is not limited solely to either softwareor hardware, and may include one or both in combination. Breakawayinterface 140 must receive examination orders at step 210. Theseexamination orders will typically be provided through radiologicalinformation system 110, but may alternatively be permitted to bereceived from other diverse systems or sources, including but notlimited to PACS 130 or other remote radiological information systems,PACS, or other systems or sources capable of providing sufficientinformation for breakaway interface 140 to generate or assembleappropriate examination orders.

Any orders that are affiliated with or would require additional workorders, for example multiple studies or procedures on a single patientusing a single imaging machine, will preferably be distinguished andassembled into a super order for that machine, as shown in steps 220 and230. Unaffiliated orders are conveyed to imaging equipment 120 asreceived, while affiliated orders are collected in step 230 and conveyedas a single super order to imaging equipment 120 in step 240. Thisconversion of work orders into rationalized work orders at step 230 isdone by breakaway interface 140, where rationalized work orders refer tosuper orders that are either assembled by or alternatively identified asmultiple procedure or multiple study work orders by breakaway interface140.

Imaging equipment 120 will generate one or more image sequences, whichin turn are received at breakaway interface 140 in step 250. Thesereceived image sequences are then analyzed and assigned as outlinedherein below with reference to method 300. The assigned images andassociated studies and work orders are then preferably transmitted toPACS 130 as shown by step 260, though transmission to other devices andequipment available either directly or through a network or otherdiverse communication channel may be used. Among the possible devicesfor transmission to, but not limiting the invention to the present list,are PACS systems, medical imaging networks, radiological informationsystems, and various storage devices for possible future use orreference.

FIG. 3 illustrates the preferred method 300 of identification of theappropriate divisions between various smaller rationalized imagesequences. In the preferred embodiment breakaway apparatus 100, method300 is the preferred means for dividing the image sequence intoseparate, anatomically associated image sequences. At step 310, an imagesequence is received from imaging equipment 120. A decision must be madeat step 315 to decide whether the work order was rationalized or not.This decision may, for exemplary purposes, be made by tracking withinbreakaway interface 140 the work orders and whether they wererationalized. In the event the work order was not a rationalized workorder, meaning the image sequence and work order have the desiredone-to-one correspondence, then the image may be directly assigned tothe order at step 340.

For rationalized work orders, individual images within an image sequencewill be analyzed beginning at step 320. As is schematically illustrated,this image analysis may include one or more techniques, eithersimultaneously or separately. Most preferred techniques include imagepixel analysis using histograms analysis, moments of order analysis, andpeak finding techniques at steps 322, 323 and 324, and will also includecomparisons of the last image analysis in step 326 and review of seriesinformation at step 328. Histogram analysis, moments of order analysisand peak finding techniques for pixel analysis are known in the graphicsindustry, and the application within the present breakaway interface 140will be within the skill of those working in the present industry upon areview of the present disclosure and without further unnecessaryelaboration. While several preferred image analysis techniques aredescribed herein, other image analysis techniques may be used or adaptedfor application herewith based upon the goals apparent from the presentdisclosure, and consequently without deviating from the presentdisclosure. In fact, owing in part to the great flexibility of thepresent invention, as image analysis techniques are introduced orrefined, they will reasonably be expected to be implemented incombination with the other features disclosed herein without departingfrom the scope of the present invention.

Information from the last analysis, as shown in step 326, represents anawareness by the present inventors that there is a sequence whichvarious image slices must occur in. In other words, a person's head isabove the neck which in turn is above the chest. Consequently, if thelast image represented a neck region image, and the imaging isproceeding from top of the head downward toward the pelvis, then thecurrent image could not reasonably be taken from the head. Step 326 isnot limited solely to the last image that was analyzed, but mayalternatively represent the last state of the complete sequence analysisas well, depending upon data storage and processing capabilitiesdesigned into breakaway interface 140.

Series information as shown in step 328 represents a check to see if thecurrent image is from the same image series and frame of reference asthe previous image. As an example, it is possible that a single imagesequence may include head and neck slices as a first procedure executedby the imaging equipment 120 and represented by a first seriesdesignation, and then also include a second imaging procedure executedby imaging equipment 120 showing chest, abdomen and pelvis slices. Insuch an instance, breakaway interface 140 will most preferably recognizethat the series information creates a logical separation of the imagesequence into distinct anatomical regions. Consequently, in such aninstance, one or more of the boundaries of division between smallerrationalized image sequences may be defined entirely by a change inimage series information.

As already noted herein above, the specific techniques for analyzingindividual images will vary from one system to another. The presentinvention uses all five steps 322-328 in the analysis, though othersystems may include any combination of steps 322-328 in any order orsimultaneously, or other image analysis techniques.

From the analysis of steps 320-328, breakaway interface 140 ispreferably programmed to determine what anatomical region the individualimage was taken from. Once determination step 330 has been completed,the individual image may be confidently assigned to one or more ordersin step 340. Preferably, at the boundaries of divisions between smallerrationalized image sequences, and where the divisions are not occurringdue to changes in series described with reference to step 328, imageswill be assigned so as to overlap between both of the adjoiningsections. Said another way, images may be duplicated between two smallerrationalized image sequences in order to adequately preserve all of theimportant features found near the boundaries of each separate imagesequence. The amount of overlap between smaller rationalized imagesequences may be'selected or configured by the user in the preferredembodiment, though this is not essential to the working of theinvention.

In accord with the preferred embodiment methods 200 and 300 illustratedin FIGS. 2 and 3 and described in detail herein above, the presentinvention performs automatic dissection of a single, multi-order imagestudy into its constituent studies. This processing occurs without auser or the PACS needing to intervene, or even needing to be aware ofthe automatic intervention and dissection.

Having thus disclosed the preferred embodiment and some alternatives tothe preferred embodiment, additional possibilities and applications willbecome apparent to those skilled in the art without undue effort orexperimentation. Therefore, while the foregoing details what is felt tobe the preferred embodiment of the invention, no material limitations tothe scope of the claimed invention are intended. Further, features anddesign alternatives that would be obvious to one of ordinary skill inthe art are considered to be incorporated herein. As but one example andcertainly not limiting of the possibilities, while breakaway interface140 is illustrated and described herein above as a separate apparatus,those skilled in the art will recognize that the function of breakawayinterface 140 may be implemented independently of physical placement. Inother words, breakaway interface 140 may be included within orimplemented in any of the remaining associated components, such as, forexample, the imaging equipment 120, without negating the functionalcharacteristics described herein above. Where one or more of thecomponents 110-130 have sufficient computational power and storage, onlysoftware appropriate to the machine may be required to implement thepresent invention Consequently, rather than being limited strictly tothe features recited with regard to the preferred embodiment, the scopeof the invention is set forth and particularly described in the claimsherein below.

We claim:
 1. A method of processing radiological orders using aradiological information system containing radiological examinationorders and associated information, a picture archive and communicationsystem, and an imaging apparatus capable of producing an image sequencehaving a plurality of individual images therein, including interfacingsaid radiological information system, said picture archive andcommunication system and said imaging apparatus in an effective andefficient manner, comprising the steps of: receiving said radiologicalexamination orders; affiliating said radiological orders using saidimaging apparatus that are each assigned to a common patient into asuper order; conveying said radiological examination orders to saidimaging apparatus for imaging; generating image sequences having atleast one individual radiological image; delivering image sequencescorresponding to said unaffiliated radiological examination orders to astorage system; analyzing said at least one individual radiologicalimage within said image sequences corresponding to said super ordersusing automated electronic image analysis comprising moments of orderanalysis and peak finding techniques to determine an associated ones ofsaid radiological orders; assigning said at least one individualradiological image to an appropriate one of said plurality of associatedstudies and work orders based upon said analyzing and determining step;and transmitting said assigned at least one individual radiologicalimage and said appropriate one of said plurality of associated studiesand work orders to said storage system.
 2. The method of processingradiological orders of claim 1 wherein said step of affiliating furthercomprises the steps of: distinguishing said radiological examinationorders that are unaffiliated with other radiological examination ordersfrom radiological examination orders that are affiliated with otherradiological examination orders; and assembling affiliated radiologicalexamination orders into a super order responsive to said distinguishing.3. The method of processing radiological orders of claim 2 wherein: saidconveying step further comprising conveying said unaffiliatedradiological examination orders and said super orders to said imagingapparatus for imaging responsive to said distinguishing and saidassembling steps; and said at least one individual radiological image isgenerated corresponding to said unaffiliated radiological examinationorders and said super orders.
 4. The method of processing radiologicalorders of claim 2 wherein said radiological examination orders arereceived from said radiological information system; said image sequencesand said unaffiliated radiological examination orders are delivered tosaid picture archive and communication system; and said at least oneindividual radiological image and said appropriate one of said pluralityof associated studies and work orders are transmitted to said picturearchive and communication system.
 5. The method of processingradiological orders of claim 1 wherein said analyzing step furthercomprises histogram analysis.
 6. The method of processing radiologicalorders of claim 1 wherein said analyzing step further comprises analysisof information from at least one previous analysis step.
 7. The methodof processing radiological orders of claim 1 wherein said analyzing stepfurther comprises evaluating series information to distinguish multipleprocedures.
 8. The method of processing radiological orders of claim 1wherein said step of determining an associated region further comprisesdetermining an associated anatomical region.